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NCP Raw Format

The document outlines a nursing care plan template that includes sections for patient information, diagnosis, care plan author, scoring criteria, nursing diagnosis, short and long term outcomes, assessment parameters, nursing orders and rationales, and actual outcomes. The template provides a framework to develop comprehensive individualized care plans.

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35 views3 pages

NCP Raw Format

The document outlines a nursing care plan template that includes sections for patient information, diagnosis, care plan author, scoring criteria, nursing diagnosis, short and long term outcomes, assessment parameters, nursing orders and rationales, and actual outcomes. The template provides a framework to develop comprehensive individualized care plans.

Uploaded by

2ryb2bbk4g
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Document

NURSING CARE PLAN QF-CN-25 Revision 1


(NCP) Code Number
Effectivity August 17, 2018 Page 1 of 2

NAME/ INITIALS OF PATIENT: AGE: SEX: STATUS:


ADDRESS: HOSPITAL: WARD:
PRINCIPAL MEDICAL DIAGNOSIS:
NURSING CARE PLAN DEVISED BY: YEAR AND SECTION: GROUP
SCORING IMPLEMENTATION
CRITERIA VL L H VH

Correct 3 5 7 10
Clean 1 2 3 5
Complete 1 2 3 5
Assessment 3 5 7 10
Parameters
Nursing 3 5 7 10
Diagnosis
Short-term 1 2 3 5
Outcome
Long-term 1 2 3 5
Outcome
Nursing Orders 3 5 7 10
(interventions)
Rationales 3 5 7 10
Actual 1 2 3 5
outcome
TOTAL SCORE

VH – Very High
H – High
L – Low
VL – Very Low

Rated by:

Name & signature of facilitator


Date:

Conforme:

Name & signature of learner


Date: ACTUAL OUTCOME DATE AND TIME-RESOLVED
NURSING CARE PLAN Document QF-CN-25 Revision 1
(NCP) Code Number
Effectivity August 17, 2018 Page 2 of 2
AND TIME NURSING DIAGNOSIS SHORT–TERM AND LONG–TERM OUTCOMES

IMPLEMENTATION
ASSESSMENT PARAMETERS NURSING ORDERS / APPROACHES RATIONALE

ACTUAL OUTCOME DATE AND TIME RESOLVED


NURSING CARE PLAN
(NCP)

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